1.Drastic Therapy for Listerial Brain Abscess Involving Combined Hyperbaric Oxygen Therapy and Antimicrobial Agents.
Keiichi NAKAHARA ; Satoshi YAMASHITA ; Katsumasa IDEO ; Seigo SHINDO ; Tomohiro SUGA ; Akihiko UEDA ; Shoji HONDA ; Tomoo HIRAHARA ; Masaki WATANABE ; Taro YAMASHITA ; Yasushi MAEDA ; Yasuhiro YONEMOCHI ; Tomohiro TAKITA ; Yukio ANDO
Journal of Clinical Neurology 2014;10(4):358-362
BACKGROUND: Listeria monocytogenes (L. monocytogenes) is a rare causative pathogen of brain abscess that is often found in immunocompromised patients. Although patients with supratentorial listerial abscesses showed a longer survival with surgical drainage, the standard therapy for patients with subtentorial lesions has not been established. CASE REPORT: We report herein a patient with supra- and subtentorial brain abscesses caused by L. monocytogenes infection. These abscesses did not respond to antibiotics, and his symptoms gradually worsened. Drainage was not indicated for subtentorial lesions, and the patient was additionally treated with hyperbaric oxygen therapy, which dramatically reduced the volume of abscesses and improved the symptoms. CONCLUSIONS: This is the first report of drastic therapy for a patient with listerial brain abscesses involving combined antibiotics and hyperbaric oxygen therapy. The findings suggest that hyperbaric oxygen therapy is a good option for treating patients with deep-seated listerial abscesses and for who surgical drainage is not indicated.
Abscess
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Anti-Bacterial Agents
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Anti-Infective Agents*
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Brain Abscess*
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Drainage
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Humans
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Hyperbaric Oxygenation*
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Immunocompromised Host
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Listeria monocytogenes